What is already known on this topic?

Gastrointestinal (GI) tract cancer is a leading cause of death and produces a heavy disease burden. GI tract cancer in the Huai River Basin was reportedly higher than the national level during 2004–2006, while current mortality rates and variations have not been reported recently.

What is added by this report?

During 2008 to 2018, significant decreases were observed in the rates of esophageal cancer (from 28.5 to 13.2 per 100,000) and stomach cancer (from 32.1 to 16.5 per 100,000). There was no statistical difference for the mortality rates of colorectal cancer, which actually showed a significant increase among men aged 45 to 54 years and women aged below 55 years. Substantial disparities exist among different sexes, age groups, and geographical regions.

What are the implications for public health practice?

These results highlight that the mortality of GI tract cancers in the Huai River Basin in 2018 are similar to national levels and still produce a heavy disease burden. More attention is needed to provide important evidence for evaluating the improvement and remaining gaps in cancer prevention and control strategies in the Huai River Basin.